Dr. Murray Feingold: Medical advances bring ethical concerns

Tuesday

Feb 22, 2011 at 12:01 AMFeb 22, 2011 at 10:17 PM

At times, advances in medicine raise ethical issues that have not been previously addressed. An example is the recent report that testing the blood of a pregnant woman can determine if her fetus has Down syndrome.

Dr. Murray Feingold

At times, advances in medicine raise ethical issues that have not been previously addressed.

An example is the recent report that testing the blood of a pregnant woman can determine if her fetus has Down syndrome.

This test can be performed because about 10 percent to 20 percent of the pregnant mother's blood contains DNA cells of the fetus.

Because Down syndrome is usually due to an extra chromosome 21, a fetus with Down syndrome will have an excessive amount of chromosome 21 DNA material. This increase in the mother's blood can be determined and when present indicates that the mother's fetus most likely has Down syndrome.

A study was done to determine the presence of a Down syndrome fetus by using this test in women who were at a high risk of having a Down syndrome baby, such as being over age 35 or having abnormal blood markers.

Results showed that the accuracy of prenatally diagnosing Down syndrome in these women was 98 percent.

Researchers believe that this type of testing will soon be available to diagnose other fetal chromosomal abnormalities. Because the test requires only a blood sample from the mother, it is possible that all pregnant women, if they so desire, can have such a test.

However, ethical and moral objections have already been raised concerning the routine use of this procedure.

The concern is that using this test will result in the selection of only the fittest fetuses to survive. Will we be developing a "super race"?

By using some of our present methods, biochemical markers, ultrasound and amniocentesis, we are already selecting out and aborting fetuses with certain abnormalities.

However, because of the ease of doing this test, it will be used on a much greater scale.

Scientific advancements, especially in the field of genetics, are proceeding at a rapid pace. Sometimes so rapidly, that the ethical considerations and consequences of these advancements have not been totally evaluated.

For some pregnant women, such ethical concerns are not a factor if all they need to do is have a blood test to determine if their fetus has a serious birth defect. For other women this presents many serious ethical issues.

What to do when such information then becomes available, to terminate or not terminate, is another agonizing decision that needs to be made.

Massachusetts-based Dr. Murray Feingold is the physician in chief of The Feingold Center for Children, medical editor of WBZ-TV and WBZ radio, and president of the Genesis Fund. The Genesis Fund is a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.